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This results in a simulation domain with significantly fewer grid cells compared to that required if all LPZs are discretized, providing potential for improved computational efficiency. Cases, including a layer of HPZ over an LPZ, a thin/thick lens of LPZ embedded in HPZ, and multiple lens of LPZs embedded in HPZ are tested by the new approach for tracer and reactive scenarios. To describe the implementation and 1-year results of a value-based bariatric surgery program in Brazil. The study was conducted at a private hospital in São Pa